Using a Simulation Pilot to improve trainee exposure to Emergencies in Paediatric Anaesthesia while training opportunities are limited by SARS-CoV-2

Since March 2020, due to the SARS-CoV-2 pandemic, paediatric surgical case numbers have reduced across the UK, including at our institution, Nottingham Children's Hospital. This has led to a reduction in trainee exposure to paediatric anaesthesia, and made it increasingly difficult to demonstrate they are 'competent at managing complications that arise in paediatric anaesthesia without immediate consultant support' as stipulated by the Higher Training Curriculum of the Royal College of Anaesthetists, UK (RCoA 2010). Informal discussions between trainees, consultant anaesthetists and educators lead to the suggestion of conducting a high fidelity simulation course to facilitate the acquisition of required competencies. Using a format similar to the well-known Managing Emergencies in Paediatric Anaesthesia (MEPA) course, we planned and ran a simulation day for a group of Higher-level anaesthetic trainees, covering a selection of paediatric emergencies outlined in the curriculum. Each trainee was given the opportunity to lead and assist in a scenario. Fidelity was enhanced by the use of the Trent Simulation and Clinical Skills Centre, a selection of relevant manikins, an operating department practitioner (ODP) with significant simulation experience, and experienced faculty including senior paediatric and general anaesthetists with experience of facilitating simulation. Candidates were invited to provide pre and post-course feedback. Scores were generally favourable, as one would expect towards the end of training. The most pronounced improvement in confidence score fell within in the communication skills, team leading and emergency management domains. All trainees reported feeling very engaged, involved, and able to contribute;the course was relevant and appropriate, and they would strongly recommend it to their colleagues. Several trainees have taken the opportunity to use scenarios to complete assessments linked to the curriculum for CCT. Our plan is now to run this course twice a year, to provide this opportunity to trainees across the East Midlands.